Chicago Tribune

(MCT)

NEW YORK - Abraham Lincoln battled it all his life. Theodore Roosevelt struggled with it even as he negotiated the end to the Russo-Japanese War. Thomas Eagleton found himself booted off a presidential ticket because of it.

So, when Massachusetts' new first lady, Diane Patrick, recently revealed that she suffers from depression and exhaustion, she joined a long line of American politicians and their loved ones hounded by what Winston Churchill called the "black dog" of depression.

With the 2008 race for the White House under way, Patrick's announcement again raises questions about the political liability of depression and how views on it have changed since Lincoln's dark days of "melancholy."

Given grueling months of insufficient sleep, too much junk food and too many germ-covered hands to shake, there's little question that politics can be hazardous to the physical health of candidates and their families.

But even in successful campaigns, the maximum scrutiny and minimal privacy also can exact a psychological toll, according to Carl Sferrazza Anthony, author of the 2000 book "America's First Families: An Inside View of 200 Years of Private Life in the White House."

"It is actually, I would say, something that has affected more presidential families than it has not," he said.

The National Institute of Mental Health (NIMH) estimates that 19 million Americans, or 1 in 10 adults, experience depression every year.

About 1 in 5 Americans will encounter depression at some point in their lives, said Lei Ellingson, assistant director of the mental health program at Atlanta's Carter Center. Among the goals of the center, founded by former President Jimmy Carter and former First Lady Rosalynn Carter in 1982, is erasing the stigma of mental illness.

Depression can be genetic, or it may result from an imbalance in the brain's biochemistry. And it can be triggered by stressful situations, including a major change in one's life.

Such a change engendered depression in Diane Patrick, who made her first public comments about her illness in a letter posted Easter night on the political Web site of her husband, Gov. Deval Patrick. Citing the "exhilarating highs and stomach-churning lows" during her husband's campaign, she wrote that she had expected life to "regain some sense of normalcy" when the campaign ended. "To my surprise, however, soon after the inauguration, I found myself aboard a new and different roller coaster. I was trying to balance my return to a full-time law practice with the unfamiliar demands of serving as first lady - all while living in a fishbowl."

Patrick spent a month "to rest and repair." She returned to her work at Ropes & Gray last week, according to a spokesman for the law firm.

Depression is highly treatable in more than 80 percent of cases, but nearly two-thirds of afflicted Americans fail to receive the help they need, according to the NIMH.

One reason is fear that depression will be seen as a weakness, said Rebecca Palpant, a senior associate at the Carter Center.

"We've really chipped away at the stigma, but, even with depression, we're still seeing discrimination," she said. She cited a lack of parity for mental illness in insurance coverage as an example.

Led by Sen. Gordon Smith, R-Ore., whose depressed young son killed himself in 2003, and Rep. Patrick Kennedy, D-R.I., who addressed his own long struggle with depression and substance abuse last year, a bipartisan coalition is pushing for a bill requiring insurers to provide equal coverage for mental and physical illness.

"We're seeing a lot of spouses coming out (about their depression)," Palpant said. She pointed to people like Tipper Gore, wife of former vice president and Democratic presidential candidate Al Gore. She spoke publicly in 1999 about her depression following a near-fatal car accident involving their son in 1989.

"With the political figure, it's easier for them to talk about it in the past tense, when they're out of office. When they're in office, it's more challenging," Palpant said.

It's even more challenging during a campaign. In 2002, the Depression and Bipolar Support Alliance, a Chicago-based organization providing help and information on mood disorders, conducted a survey on the political impact of mental illness. Of 1,200 American adults polled, 52 percent said they would vote for a candidate for national office who had once been diagnosed with depression.

However, the same survey showed that where all other factors were equal nearly 24 percent would not vote for a candidate who had been diagnosed with clinical depression, and another 24 percent said they "might not" vote for them.

The survey was taken 30 years after Sen. Thomas Eagleton, D-Mo., was dropped as the running mate of Sen. George McGovern, D-S.D., on the 1972 Democratic presidential ticket.

Besieged by newspaper editorials calling for his removal, Eagleton stepped aside after it was reported, and he confirmed, that he had been hospitalized for depression and received electroshock therapy in the 1960s.

Nearly 20 years later, former Sen. Lawton Chiles, D-Fla., in his 1990 Florida gubernatorial race, received a different reaction when he immediately confirmed rumors that he took Prozac for depression.

Chiles pointed out that many presidents had depression, including Lincoln, noting, "Nobody is going to argue that it affected his performance in office." Chiles went on to win the Democratic nomination and defeat the GOP incumbent.

"I think the route to go is obviously what Chiles did," said Lawrence Strout, director of the mass communication program at Xavier University of Louisiana in New Orleans, who published a paper comparing the Eagleton and Chiles cases.

Even if handled well, depression remains a potential political minefield. "Everything's a liability. Politicians run very scared. That's how they win," said Doug Wead, a former special assistant to President George H.W. Bush and author of "All the Presidents' Children: Triumph and Tragedy in the Lives of America's First Families" in 2003.

For members of political families, depression often stems from what Wead calls "the curse of power and the expectations that come from it."

Born in 1951, Diane Patrick announced her illness on March 10, about nine weeks after her Chicago-born husband became the first black governor of Massachusetts. Patrick, a mother of two and partner in a high-powered Boston law firm, campaigned vigorously for her Democrat husband during what many consider one of the nastiest gubernatorial races the state had ever seen.

Following her husband's strong win in November, Diane Patrick said she planned to be a high-profile first lady but rarely appeared since his January inauguration. Former Massachusetts governor and Democratic presidential candidate Michael Dukakis, a close friend of the Patricks, declined to discuss the issues posed by depression in political families. But he is well aware of them. His wife, Kitty, wrote about her depression in her 1990 book "Now You Know." More recently, she wrote "Shock: The Healing Power of Electroconvulsive Therapy," describing the treatment that finally worked against her chronic depression.

Kitty Dukakis, like so many past and present depressives in the political world, doubtless could empathize with Lincoln's description of the pain of depression:

"I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would be not one cheerful face on earth. Whether I shall ever be better, I cannot tell. I awfully forebode I shall not. To remain as I am is impossible. I must die or be better it appears to me."